It is widely recognized that HIV and human rights are inextricably linked, partly due to health inequities faced by vulnerable populations, including youth (Avert, 2019). Despite this recognition, to date, no studies have examined impacts of various psychosocial factors (i.e., HIV transmission literacy, HIV medication adherence, HIV [non-]disclosure, and self-esteem) among youth living with HIV in Namibia.
Method: For this study, 188 youth living with HIV were recruited from a healthcare center in Namibia to complete a structured survey. The survey included The Case Adherence Index (Mannheimer et al, 2006), the Major Depression sub-scale of the Revised Child Anxiety and Depression Scale (Chorpita et al., 2015), The Rosenberg Self-Esteem Scale (Rosenberg, 1965), as well as questions developed to estimate levels of knowledge related to HIV transmission, and a single item to measure disclosure of HIV status. Questions related to socio-demographic variables were also included.
Results: The average age in the sample was 16 years, ranging from 10 to 21. About 63% of the sample were female, 15% percent lived with grandparents, 22% had not disclosed their status to anybody, and more than one-third experienced food insecurity. A hierarchical regression analysis revealed that higher levels of HIV transmission literacy (b = .348, p < .05) and adherence to treatment medication (b = .261, p < .01) were both positively and significantly associated with self-esteem. Conversely, HIV status disclosure (b = -1.754, p < .05) had a significant negative effect on self-esteem in this sample. Higher levels of depressive symptoms were significantly related to lower levels of self-esteem (b = -.277, p < .001). Finally, having grandparents as primary caregivers (b = 2.157, p < .05) had a positive effect on self-esteem.
Conclusion and Implications: This study found that youth living with HIV who reported higher levels of HIV transmission literacy, greater adherence to HIV treatment, and had grandparents as primary caregivers had higher self-esteem. Whereas disclosure of HIV status and higher levels of depressive symptoms had negative effects on self-esteem. These findings call for the development and expansion of more culturally appropriate, preventative, and youth-focused HIV interventions.